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A 56 year old male was brought into the Emergency Department, he was comatose with hypothermia, hypotonia, hyporeflexia, hypotension, conjunctival injection , slow respiration, acidotic breathing, In ED he was administered Thiamine 100mg IV and get better.

Wernicke's encephalopathy from alcohol intoxication..thiamin is essential for carbohydrate metabolism and is defficient with chronic alcoholism..the presesntation is a form of reversible thiamin deficiency

I would say the patient had Wernicke's encephalopathy due to alcohol intoxication. It is reversible.Thiamine is a cofactor for several important enzymes and may also be involved in conduction of the axon potential along the axon and in synaptic transmission.

Symptoms are suggestive of hypoglycemia and not of wernickes or isolated thiamine def.alcoholic, acute on chronic thiamine def. lead to hypoglycemia and thus the symptoms. treated with dextrose and thiamine.

Chronic alcohol intake leads to a deficiency of thiamine which in turn results in serious brain disorder, including Wernicke-korsakoff syndrome. As thiamine plays an imprtant role as a cofactor in metabolism of carbohydrate, i think it is helpful in this case to prevent further CNS damage.

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